To Evaluate the Effects of Adjuvant Clonidine in Combination with Bupivacaine, As Compared to Solo Bupivacaine for Axillary Brachial Plexus Block: A Comparative Assessment
Authors/Creators
- 1. Assistant Professor, Department of Anaesthesiology, SCB Medical College, Cuttack, Odisha, India
- 2. Associate Professor, Department of Anaesthesiology, DD Medical College, Keonjhar, Odisha, India
Description
Background: The extension of axillary block is advantageous in numerous cases as it permits a more protracted or comprehensive surgical procedure while reducing the need for additional analgesic medications. In this study, we conducted a comparative analysis of the efficacy of Clonidine as an adjuvant to Bupivacaine (0.5%) and Bupivacaine plain in the context of axillary brachial plexus block. The Visual Analogue Scale (VAS) score and other block characteristics were systematically assessed at regular intervals and in the postoperative period. Methods: A cohort comprising 110 adult patients classified under ASA 1, 2, and 3 were systematically assigned to two distinct groups using an alternate allocation method. In this study, Group A was administered a solution containing 0.25% Bupivacaine (40 mL) along with 1 mL of clonidine at a concentration of 150μg. On the other hand, Group B received a solution consisting of 0.25% Bupivacaine (40 mL) along with 1 mL of 0.9% saline. These solutions were administered via perivascular Axillary block. Results: The patient cohorts exhibited similarities in regards to age, gender, presence of concurrent medical conditions, and American Society of Anesthesiologists (ASA) classification. In the bupivacaine clonidine cohort, the duration of analgesia was extended by an average of 208 minutes in comparison to the administration of bupivacaine alone. The initiation of sensory and motor blockade was reduced by an average of 2.7 minutes and 3 minutes, respectively, in the clonidine treatment cohort. The average duration of sensory block in the bupivacaine-clonidine group was 503.3 ± 125.9 minutes, whereas in the bupivacaine only group, it was 287.1 ± 82.9 minutes. The results indicate a notable extension in the clonidine cohort, amounting to approximately 216.2 minutes. The average duration of motor block in the bupivacaine-clonidine group was found to be 409.8 minutes, whereas in the bupivacaine only group, it was observed to be 259.6 ± 74.8 minutes. This indicates a statistically significant increase in duration of 150.2 minutes in the clonidine treatment group. The study observed several side effects, namely hypotension, bradycardia, and sedation. The incidence rates of these side effects were 7.3%, 9.1%, and 36.3%, respectively, in the bupivacaine-clonidine group. In comparison, the bupivacaine only group had incidence rates of 1.8%, 3.6%, and 9.1%, respectively. Conclusion: Clonidine serves as a valuable adjunct to bupivacaine in the context of Axillary block. It greatly extends the period of pain relief, as well as the duration of sensory and motor blockade. Additionally, it expedites the initiation of sensory and motor blockade, albeit to a lesser extent.
Abstract (English)
Background: The extension of axillary block is advantageous in numerous cases as it permits a more protracted or comprehensive surgical procedure while reducing the need for additional analgesic medications. In this study, we conducted a comparative analysis of the efficacy of Clonidine as an adjuvant to Bupivacaine (0.5%) and Bupivacaine plain in the context of axillary brachial plexus block. The Visual Analogue Scale (VAS) score and other block characteristics were systematically assessed at regular intervals and in the postoperative period. Methods: A cohort comprising 110 adult patients classified under ASA 1, 2, and 3 were systematically assigned to two distinct groups using an alternate allocation method. In this study, Group A was administered a solution containing 0.25% Bupivacaine (40 mL) along with 1 mL of clonidine at a concentration of 150μg. On the other hand, Group B received a solution consisting of 0.25% Bupivacaine (40 mL) along with 1 mL of 0.9% saline. These solutions were administered via perivascular Axillary block. Results: The patient cohorts exhibited similarities in regards to age, gender, presence of concurrent medical conditions, and American Society of Anesthesiologists (ASA) classification. In the bupivacaine clonidine cohort, the duration of analgesia was extended by an average of 208 minutes in comparison to the administration of bupivacaine alone. The initiation of sensory and motor blockade was reduced by an average of 2.7 minutes and 3 minutes, respectively, in the clonidine treatment cohort. The average duration of sensory block in the bupivacaine-clonidine group was 503.3 ± 125.9 minutes, whereas in the bupivacaine only group, it was 287.1 ± 82.9 minutes. The results indicate a notable extension in the clonidine cohort, amounting to approximately 216.2 minutes. The average duration of motor block in the bupivacaine-clonidine group was found to be 409.8 minutes, whereas in the bupivacaine only group, it was observed to be 259.6 ± 74.8 minutes. This indicates a statistically significant increase in duration of 150.2 minutes in the clonidine treatment group. The study observed several side effects, namely hypotension, bradycardia, and sedation. The incidence rates of these side effects were 7.3%, 9.1%, and 36.3%, respectively, in the bupivacaine-clonidine group. In comparison, the bupivacaine only group had incidence rates of 1.8%, 3.6%, and 9.1%, respectively. Conclusion: Clonidine serves as a valuable adjunct to bupivacaine in the context of Axillary block. It greatly extends the period of pain relief, as well as the duration of sensory and motor blockade. Additionally, it expedites the initiation of sensory and motor blockade, albeit to a lesser extent.
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IJPCR,Vol15,Issue7,Article46.pdf
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Additional details
Dates
- Accepted
-
2023-06-21
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue7,Article46.pdf
- Development Status
- Active
References
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